501
Candidate Intention Statement
Type or P_r1nt In Ink.
Check One: ~nitial
o Amendment (explain)
1. Candidate Information: / J J . A~'1. 1.. '~A
NAME OF CANDIDATE (Laat. Firat. Middle InIIiBI) we, .J c....rt. r'fIIWt'\
STREET ADDRESS
/()/~.3 tVill/J4!~HJf)j:. ~
OFFICE ~G (POSITION TITLE)
- (;f.' ~M1eAJW
OFFICE JU IcnON
o State (CompIe/B PIJIt 2.)
[Jit'Crty 0 County 0 Multi-County:
DAYTIME TELEPHONE NUMBER
<HS> 7~"-J/IIg
CITY
''r!:inIJ
FAX NUMBER (opIIonaI)
<4'1?J! "'7!Jf5b
STATE
CA
E-MAIL (op/ion8/)
cA/~M~~PSftutJi;''es'.()11J
ZIP CODE '"
9.t~;.
DISTRICT NUMBER, /I app//cabIe.
ARTISAN
PARTY:
(Name oflfUl.County.lllladldlon)
Z()l)I'
('IHr of EJedJon)
2. State Candidate Expenditure Limit Statement:
(CslPERS C81IdIdat8s, judges. judlcIaJ candidates, and candidates for Ioc8I offices _ not 18qufred to comp/ste PBrl 2.)
Primary/general elect/on
(YHI'ofEltlcfion)
Spec/aVrunoff election
(y--of SIIcIIon)
(Check """bolt)
o I accept the voluntary expenditure ceiling for the election stated above.
o I do not accept the voluntary expenditure ceiling for the election stated above.
Amendment
o I did not exceed the expenditure ceiling in the primary or special election held on: ---1---1_ and I accept the voluntary expenditure ceiling for the
general or special run-off election.
(Marlr If applicable)
o On ---1---1_ I contributed personal funds in excess of the expenditure ceiling for the election stated above.
3. Verification: _
I certify under penalty of pe~ury_ under the _ of tho Slate of Call1omla that tho ~
Executed on (5)c:e- /5 '" ~, . Signature
(month, day. yeatj
"
F.PPC Form 501 (Januaryl85)
FPPC TolI-F.... Helpline: 8661ASK-FPPC (816127Wm)